Exploring The Potentials Of Mama Kit On Antenatal Care Uptake And Delivery InHealth Facilities: A Qualitative Study Among Pregnant Women In Benue RuralCommunities
Keywords:
Antenatal Care, Delivery, Health facility, Incentives, Mama kitAbstract
Maternal and neonatal health constitutes a significant concern within public health domains, particularly in low and middle-income nations, with a great emphasis on rural Nigeria where the engagement with antenatal care (ANC) and health facility delivery services remains inadequate. This study sought to assess the potentials of Mama kits as a motivational tool aimed at enhancing ANC attendance and health facility delivery rates among pregnant women residing in rural communities of Benue State. The research was carried among twelve rural communities, encompassing a sample of 72 pregnant women selected through purposive sampling techniques. Data collection was through nine Focused Group Discussions (FGDs), stratified by demographic factors such as age, parity, and literacy levels, and subsequently analyzed utilizing thematic analysis supported by NVivo-12 Pro software. The results indicated a generally good ANC attendance, with the majority of participants adhering to their scheduled clinic appointments. Factors motivating ANC engagement included the provision of early pregnancy care, the management of health-related complications, and the availability of medicinal resources. Nevertheless, several barriers were identified, including the absence of qualified health personnel, insufficient diagnostic services, and the negative attitudes exhibited by certain healthcare providers. The decision to deliver at health facilities was influenced by the perceived quality of care, the presence of skilled attendants, and apprehension regarding potential complications. Despite these factors, financial limitations—especially concerning the costs associated with delivery materials—and sporadic poor attitudes from staff emerged as significant impediments. Notably, all participants showed willingness to utilize health facilities for childbirth if Mama kits were made available at no cost. The kits were perceived as alleviating financial burdens and fostering sustained engagement with maternal health services. Additionally, participants expressed their intent to advocate for such initiatives within their respective communities. In conclusion, integration of such incentive-based strategies within maternal health programs holds potential for substantially enhancing maternal and neonatal health outcomes in rural Nigeria.
References
1. Anyanwu EC, Maduka CP, Ayo-Farai O, Okongwu CC, Daraojimba AI. Maternal and child health policy: A global review of current practices and future directions. World Journal of Advanced Research and Reviews. 2024 Feb 28;21(2):1770-81. https://doi.org/10.30574/wjarr.2024.21.2.0306
2. Oloruntosin M, Sunkanmi M, Oyewole Alawode G, Oduh S, Iwuoha J. Review of Policy Initiatives on Maternal Mortality in Nigeria [Internet]. doi:10.47772/IJRISS
3. Ayele BA, Holliday E, Chojenta C. Determinants of antenatal care service utilisation in sub-Saharan Africa: an analysis of demographic and health surveys data (2015–2022). Archives of Public Health. 2025 Dec 1;83(1). doi:10.1186/s13690-025-01608-1 PubMed PMID: 40676660.
4. Ganle KK, Parker M, Fitzpatrick R, Otupiri E. A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition. BMC Pregnancy Childbirth. 2014 Dec 21;14(1). doi:10.1186/s12884-014-0425-8 PubMed PMID: 25527872.
5. Kurniati A. Improving Maternal and Neonatal Health Outcomes: A Comparative Study of Antenatal Care Interventions. Join: Journal of Social Science. Available from: https://ejournal.mellbaou.com/index
6. Abid MstT, Kulsum U, Sultana S, Razia S, Chowdhury AH. Relationship between Antenatal Care and Pregnancy Outcome among Participants of a Rural Upazilla Health Complex in Bangladesh. Scholars International Journal of Obstetrics and Gynecology. 2024 Sep 26;7(09):469–76. doi:10.36348/sijog.2024.v07i09.012
7. Enhancing, and protecting, maternal and neonatal health care Lancet.
8. Nshiowo KC, Owopetu CA. 2022) Mothers' Experiences of Delivery Services by Traditional Birth Attendants at Egbe Community, Yagba West Lga Kogi State. International Journal of Nursing, Midwife and Health Related Cases [Internet]. 2022;8(2):35–52. Available from: https://www.eajournals.org/
9. Murray SF, Hunter BM, Bisht R, Ensor T, Bick D. Effects of demand-side financing on utilisation, experiences and outcomes of maternity care in low-and middle-income countries: a systematic review [Internet]. 2014. Available from: http://connect.jbiconnectplus.org/View-
10. Austin-Evelyn K, Sacks E, Atuyambe L, Greeson D, Kruk ME, Grépin KA. The promise of Mama Kits: Perceptions of in-kind goods as incentives for facility deliveries in Uganda. Glob Public Health. 2017 May 4;12(5):565–78. doi:10.1080/17441692.2016.1149597 PubMed PMID: 26948028.
11. Kitui JE, Dutton V, Bester D, Ndirangu R, Wangai S, Ngugi S. Traditional Birth Attendant reorientation and Motherpacks incentive's effect on health facility delivery uptake in Narok County, Kenya: An impact analysis. BMC Pregnancy Childbirth. 2017 Apr 21;17(1). doi:10.1186/s12884-017-1307-7 PubMed PMID: 28431565.
12. Wang P, Connor AL, Guo E, Nambao M, Chanda‐Kapata P, Lambo N, Phiri C. Measuring the impact of non‐monetary incentives on facility delivery in rural Zambia: a clustered randomised controlled trial. Tropical Medicine & International Health. 2016 Apr;21(4):515-24. https://doi.org/10.1111/tmi.12678
13. Leight J, Sharma V, Brown W, Costica L, Sule FA, Nyqvist MB. Associations between birth kit use and maternal and neonatal health outcomes in rural Jigawa state, Nigeria: A secondary analysis of data from a cluster randomized controlled trial. PLoS One. 2018 Dec 1;13(12). doi:10.1371/journal.pone.0208885 PubMed PMID: 30586441.
14. Akinsola KO, Olasupo O, Salako J, Sanaka JZ, Samuel RN, Bakare O, et al. “I went to the primary health centre close to my workplace, but their capacity cannot deliver the baby”: exploring why women choose different providers for maternal health services in Nigeria. BMC Pregnancy Childbirth. 2025 Dec 1;25(1). doi:10.1186/s12884-025-07382-w PubMed PMID: 40133936.
15. Colomar M, Cafferata ML, Aleman A, Tomasso G, Betran AP. Supply kits for antenatal and childbirth care during antenatal care and delivery: A mixed-methods systematic review, the qualitative approach. Reproductive Health. BioMed Central Ltd.; 2017. doi:10.1186/s12978-017-0299-0 PubMed PMID: 28359337.
16. Adukwu BO. Factors affecting maternal health care services utilization among rural women with low literacy in minority communities, Benue State, Nigeria. Southern Connecticut State University; 2015.
17. Hurst TE, Semrau K, Patna M, Gawande A, Hirschhorn LR. Demand-side interventions for maternal care: Evidence of more use, not better outcomes. BMC Pregnancy Childbirth. 2015 Nov 13;15(1). doi:10.1186/s12884-015-0727-5 PubMed PMID: 26566812.
18. Alatinga KA, Affah J, Abiiro GA. Why do women attend antenatal care but give birth at home? a qualitative study in a rural Ghanaian District. PLoS One. 2021 Dec 1;16(12 December). doi:10.1371/journal.pone.0261316 PubMed PMID: 34914793.
19. Hill Z, Scheelbeek P, Schellenberg J, Hamza Y. “Everything is from God but it is always better to get to the hospital on time”: A qualitative study with community members to identify factors that influence facility delivery in Gombe State, Nigeria. Glob Health Action. 2020 Dec 31;13(1). doi:10.1080/16549716.2020.1785735 PubMed PMID: 32666908.
20. Ijaiya MA, Saka MJ, Aderibigbe SA, Raji HO, Adeniran AS, Ijaiya ZB, Ameen HA, Uthman MM, Kayode B, Abdulraheem I, Bolarinwa OA. Determinants of Choice of Facility-Based Delivery among Mothers in Kwara State, Nigeria. West African Journal of Medicine. 2023 Jun 1;40(6):594-600.
21. Tohan MM, Islam MA, Rahman MA. Exploring the factors behind socioeconomic inequalities in Antenatal Care (ANC) utilization across five South Asian natiaons: A decomposition approach. PLoS One. 2024 Aug 1;19(8 AUGUST). doi:10.1371/journal.pone.0304648 PubMed PMID: 39110696.
22. Jones L, Damayanti NA, Wiseman N, Harris N. Factors Shaping Uptake of Antenatal Care in Surabaya, Indonesia: a Qualitative Study [Internet]. 2020. Available from: https://www.researchsquare.com/article/rs-48436/v1 doi:10.21203/rs.3.rs-48436/v1
23. Thompson O. 'Beyond our pregnancies and bodies': benefits and barriers to antenatal care clinic utilisation among pregnant women in Abeokuta, southwest Nigeria. African Identities. 2025;23(3):878–95. doi:10.1080/14725843.2024.2388180
24. Ibrahim UM, Gajida AU, Jalo RI, Takai UI, Jibo AM, Saleh Y, et al. Barriers to Utilization of Antenatal Care Interventions among Pregnant Women Attending Primary Health Care Centres in Kano, Nigeria. borno medical journal. 2020 Dec 31;17(2):1–9. doi:10.31173/bomj.bomj_199_17
25. F O. Exploring Barriers and Facilitators of Group Antenatal Care Implementation in Kaduna State, Nigeria: A Qualitative Evaluation. Vaccines & Vaccination Open Access. 2024 Jul 17;9(2):1–11. doi:10.23880/vvoa-16000177
26. Kawaguchi Y, Sayed AM, Shafi A, Kounnavong S, Pongvongsa T, Lasaphonh A, et al. Factors affecting the choice of delivery place in a rural area in Laos: A qualitative analysis. PLoS One. 2021 Aug 1;16(8 August). doi:10.1371/journal.pone.0255193 PubMed PMID: 34339442.
27. Mshelia SE, Analo C V., Booth A. Factors influencing the utilisation of facility-based delivery in Nigeria: a qualitative evidence synthesis. J Glob Health Rep. 2020;4. doi:10.29392/001c.17961
28. Ossai EN, Eze II, Eke PC, Onah CK, Agu C, Ogbonnaya LU. Where, why and who delivers our babies? Examining the perspectives of women on utilization of antenatal and delivery services in a developing country. BMC Pregnancy Childbirth. 2023 Dec 1;23(1). doi:10.1186/s12884-022-05306-6 PubMed PMID: 36593447
29. Rahman MA, Rahman MA, Rawal LB, Paudel M, Howlader MH, Khan B, et al. Factors influencing place of delivery: Evidence from three south-Asian countries. PLoS One. 2021 Apr 1;16(4 April). doi:10.1371/journal.pone.0250012 PubMed PMID: 33831127.
30. Sumankuuro J, Crockett J, Wang S. Perceived barriers to maternal and newborn health services delivery: A qualitative study of health workers and community members in low and middle-income settings. BMJ Open. 2018 Nov 1;8(11). doi:10.1136/bmjopen-2017-021223 PubMed PMID: 30413495.
31. Tukur I, Cheekhoon C, Tinsu T, Muhammed-baba T, Aderemi Ijaiya deen. Why Women Are Averse to Facility Delivery in Northwest Nigeria: A Qualitative Inquiry. Iran J Public Health [Internet]. 2016. Available from: http://ijph.tums.ac.ir
32. Webber GC, Chirangi BM, Magatti NJ. Challenges and successes of distributing birth kits with misoprostol to reduce maternal mortality in rural Tanzania. Afr J Reprod Health. 2019;23(3):68–78. doi:10.29063/ajrh2019/v23i3.7 PubMed PMID: 31782633.
33. Al-Mujtaba M, Shobo O, Oyebola BC, Ohemu BO, Omale I, Shuaibu A, et al. Experiences with facility delivery services within the context of a maternal neonatal health project in Gombe State, Northeast Nigeria A qualitative study [Internet]. 2023. Available from: https://www.researchsquare.com/article/rs-2454705/v1 doi:10.21203/rs.3.rs-2454705/v1.
